Wednesday, February 17, 2016

Is Treatment for Alcohol Use Disorder Associated with Reductions in Criminal Offending? A National Data Linkage Cohort Study in England

BACKGROUND:

This
is the first English national study of change in criminal offending following
treatment for alcohol use disorder (AUD).

METHODS:

All
adults treated for AUD by all publicly funded treatment services during April
2008-March 2009 (n=53,017), with data linked to the Police National Computer
(April 2006-November 2011). Pre-treatment offender sub-populations were
identified by Latent Profile Analysis. The outcome measure was the count of
recordable criminal offences during two-year follow-up after admission. A
mixed-effects, Poisson regression modelled outcome, adjusting for demographics
and clinical information, the latent classes, and treatment exposure covariates.

RESULTS:

Twenty-two
percent of the cohort committed one or more offences in the two years
pre-treatment (n=11,742; crude rate, 221.5 offenders per 1000). During
follow-up, the number of offenders and offences fell by 23.5% and 24.0%,
respectively (crude rate, 69.4 offenders per 1000). During follow-up, a lower
number of offences was associated with: completing treatment (adjusted incident
rate ratio [IRR] 0.82; 95% confidence interval [CI] 0.79-0.85); receiving
inpatient detoxification (IRR 0.84; CI 0.80-0.89); or community pharmacological
therapy (IRR 0.89; CI 0.84-0.96). Reconviction was reduced in the
sub-population characterised by driving offences (n=1,140; 11.7%), but was
relatively high amongst acquisitive (n=768; 58.3% reconvicted) and violent
offending sub-populations (n=602; 77.6% reconvicted).

CONCLUSIONS:

Reduced
offending was associated with successful completion of AUD treatment and receiving
inpatient and pharmacological therapy, but not enrolment in psychological and
residential interventions. Treatment services (particularly those providing
psychological therapy and residential care) should be alert to offending,
especially violent and acquisitive crime, and enhance crime reduction
interventions.